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Approaches to asthma Correction |
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 hildren in Atlanta will breathe easier because of ZAP Asthma, the innovative partnership between the HMOs and their community partners. But the benefits won't stop with these young people. What is learned fr
om this program will enable us to replicate similar collaborative programs throughout the country in efforts to tackle local public health problems.
Thank you for focusing on the ZAP Asthma program in Public Health. As the delivery and financing of health care programs continue to emerge and the health needs of our populations change, it will take all of us working together - in progra ms like ZAP Asthma - if we are to be successful in making our communities healthier and better places in which to live. Carmella Bocchino |
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 our recent article, Asthma Zappers, provides an excellent overview of the Zap Asthma program currently being conducted in Atlanta. The program is unique in that, from the beginning, the community has been in
volved in the design and implementation of all aspects. It is an anomalous approach to the management and control of chronic disease: the impetus for the program comes from the community itself and not from outside sources.
Will Zap Asthma succeed? The answer is an emphatic yes. There are two reasons for this optimism: First, the timing is right for Zap Asthma. With an ever-changing health care system, more and more Americans are actively seeking greater responsibility ov er their health and health care needs. Most want to work within the framework of traditional medicine. The response has been more and more programs like Zap Asthma that integrate the knowledge and skills of patients into the management of illness, particu larly chronic illness. Secondly, Zap Asthma is a departure in that it is a program designed by members of the community for use with people living within the community. Community health workers are invested in the program because they are providing assist ance to their neighbors, friends, and relatives; children and families in the inner city, in turn, are being taught by people they know who understand their illness and how it can be controlled. Thomas L. Creer, PhD |
 hat an excellent article on Atlanta's ZAP Asthma project. I was delighted to learn about your community-based asthma prevention model and its affiliation with the American Association of Health Plans.
As a health data analyst at Principal Health Care of Illinois, I am involved with quality improvement efforts regarding asthma. Your article helped me to identify similar efforts in the Chicago area. For its asthma prevention initiative, Chicago has de veloped a consortium of partners with more than 50 governmental, private, and public representatives. The initiative at my company, which will be modeled after Atlanta's ZAP Asthma, will highlight our commitment to eradicating this chronic condition in ch ildren. Thanks to Drs. Joyce Essien and Lawrence Sanders for helping me identify similar efforts in Chicago. Also, special thanks to Public Health magazine for highlighting this project. Indeed, my public health background has served me well. Clemon Ashley, MPH 97 |
 hank you for describing the ZAP Asthma study in your recent article. While asthma is not a new disease, its increasing incidence nationally and in Atlanta makes it a major public health problem requiring cre
ative solutions involving collaboration between community groups, government, business, and the health care industry.
Last year, President Clinton created the President's Task Force on the Protection of Children from Environmental Health and Safety Risks to identify, prioritize, and deal with environmental and safety threats to children. In April, the task force selec ted asthma as one of its four high priority areas of focus for the federal government. It also identified community-based partnerships as one of the most desirable ways to prevent asthma in children. The ZAP Asthma study will provide important information to all federal agencies participating in this endeavor by adding to our understanding of those intervention techniques most helpful in the prevention of asthma attacks. In addition, it will provide valuable insights into the level of community participat ion needed for families to have more control over this debilitating, costly, and sometimes fatal disease. The United States Environmental Protection Agency recently launched a national community-based pilot initiative called the Child Health Champion Communities program. It is designed to help community members take steps to protect their children from loc al environmental health threats such as asthma. The Child Health Champion Communities focus on building community collaboration among diverse groups to prioritize local environmental health hazards, set realistic goals, develop community-specific action p lans to reduce such hazards, and work together to implement those plans. Many of the 11 pilot communities have selected asthma as one of their local priority issues. We are excited about the potential results from the ZAP Asthma program and how they could inform the development of other community-based initiatives such as the Child Health Champion Campaign. We applaud the participants of this ground-breaking work and look forward to the findings. Liz Blackburn and Edward Chu |
| he coverage you provided of Atlanta's ZAP Asthma program is thought-provoking to many of us in Chicago who hope to replicate some of the health outcomes sought in Atlanta. Indeed, as the article mentioned, o
ne of the hallmarks of the Atlanta program is the inspiration it has provided to coalitions in other cities, including Chicago, where Regional Health and Human Services Director Hannah Rosenthal has initiated a planning process with many of the same key e
lements that contributed to the success of ZAP Asthma.
While challenges facing Chicago are in many ways similar to those encountered in Atlanta, some key differences have necessarily influenced our planning efforts to date. One issue is that of scale. As we have sought to find an appropriate jurisdiction for
program implementation - one in which asthma morbidity is significant and in which the community mobilization to address asthma is high - we have found several neighborhoods which fit this description with populations that far exceed the 50,000 residents
served by the Atlanta program.
The ZAP Asthma planning process holds great promise for Chicago. My colleagues and I look forward to a robust application of the very strong ZAP Asthma program, which your coverage summarized so well. Linda Diamond Shapiro |
 very much enjoyed reading your recent article about the Zap Asthma project. The program is similar to one we have developed in Chicago, in which peer educators work with parents of children with asthma in t
he inner city of Chicago to modify environmental factors in the home which could affect morbidity from the disease. We have found that parents of children with asthma are often motivated and especially suited to work with other families of children with t
he disease. Their knowledge of barriers facing inner city families and creativity in overcoming those barriers cannot be duplicated by other health care professionals. Currently, we have programs similar to Zap Asthma based in Headstart Programs, Chicago
Public Schools, and Community Health Centers. In all these setting, our educators have been well received and the families with whom they are working are grateful.
Victoria Persky, MD
Rhonda Mullen, editor |
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appreciated the article on my research in the Spring 1998 issue of your magazine. However, I was concerned with a number of factual errors. In particular, the description of my activities on the Women's Con
traceptive and Reproductive Experiences Study was incorrect. Dr. Jonathan Liff is the principal investigator of the study at Emory. I joined the study as a co-investigator in 1996, after the study had been ongoing for several years, and therefore, I did n
ot participate in the development of any instruments used in the study, including the life events calendar.
Life events calendars have been used to obtain personal histories from subjects for demographic and research purposes for several decades (Casey, et al., Journal of Psychosomatic Research 1967;11:239-47; Wingo, et al., American Journ al of Epidemiology 1988;128:206-17). Recently I participated in a pilot study, with my colleagues Drs. Paige Tolbert and Jane Hoppin in the Department of Environmental and Occupational Health, in which we developed a life events calendar to elicit occupational history from farmers (Hoppin, et al., American Journal of Industrial Medicine, in press). Although the results from this pilot may be used in a future case-control study of prostate cancer risk factors among African Americans, th at work has yet to be proposed or funded (as implied by your feature). Thank you for this opportunity to provide clarifications. Elaine W. Flagg |
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Fall 1998 Issue | Dean's Message | School Sampler | Letters
Summer School in Guatemala | Double Dose
An Exchange of Ideas | Back to the Classroom | Trading Places
Alumni Sampler | Philanthropy | Commencement 1998
WHSC | RSPH
Copyright © Emory University, 1998. All Rights Reserved.
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Web version by Jaime Henriquez.